What You Need to Know About Sinusitis and Sinus Surgery

When a patient is diagnosed with chronic sinusitis that has not responded to medication, surgery may provide needed relief. Ghassan J. Samara, MD, a leader on the rhinology team of the Otolaryngology-Head and Neck Surgery Division at Stony Brook Medicine, discusses the problems of sinusitis and the minimally invasive surgical treatments for it, including the novel Propel® stent, available at Stony Brook. 

What is chronic sinusitis? 
Chronic sinusitis is characterized by chronic inflammation of the sinuses that has lasted for three months or longer. The sinuses are air spaces in the bones of the face. When these air spaces get chronically inflamed, it can lead to many other problems such as polyps and infections. 

What are the symptoms? 
You may have sinus pain and/or pressure, trouble breathing, a diminished sense or smell and/or taste, persistent nasal discharge and even fatigue. 

What causes sinusitis? 
When you have an allergy or a cold, it creates swelling of the sinus lining, which can close up the openings and prevent bacteria from exiting. The bacteria stay in the sinuses where they have a chance to overgrow, and that can lead to infection. Or you may have a polyp in your sinus, causing a blockage.

How can someone prevent sinusitis? 
The first course is to try to avoid a chronic situation. Clean up your local environment such as your home and your office. Don’t live with allergy triggers like dust, mold, tobacco smoke or animals that you’re allergic to. In your office, copier machines and other equipment give off fumes that can cause irritation and lead to infection, so you should try to avoid regular contact.

What are common medical treatments? 
Nasal steroids, long-term antibiotics, oral steroids, inflammation-blocking medications and saline nasal rinses. When medical therapy no longer works, surgery may be an option.

Which surgical treatments are typically used to treat chronic sinusitis?
The most common surgeries are standard endoscopic procedures, which are minimally invasive and involve using a very narrow lighted tube inserted through the nostrils. The tube allows us to see exactly where there are any obstructions, which we can then remove. We also perform balloon sinuplasty. With this minimally invasive procedure, a tiny, high-strength plastic balloon is inserted and inflated in the sinus cavity. This can open up the sinus without harming the sinus lining. We are also now using an exciting technology called Propel.

What is Propel? 
Propel is a stent that’s placed in the sinus following a procedure to open it. The Propel stent helps keep the sinus open, while simultaneously delivering anti-inflammatory medicine directly to the sinus tissue. Within a month or so, the stent dissolves on its own.

What are the benefits of Propel? 
While surgery helps many patients, inflammation and scarring can occur postoperatively, diminishing the desired outcome of surgery or causing symptoms to return. With the Propel stent, the potentially harmful inflammation and scarring are reduced.

Why should someone choose Stony Brook for sinus surgery? 
One thing that makes Stony Brook unique is our use of imaging guidance, which is like having a GPS to help navigate the surgery. We use CT scan information to build a computerized 3D model of the patient’s head. Imaging guidance is especially useful for complicated surgeries, as well as revision surgeries. When someone had surgery done before, their anatomy may have been altered. Being able to see exactly what the patient’s anatomy looks like can make the operation safer. At Stony Brook, we perform thousands of sinus surgeries every year — from the simplest to the most complex. Our board-certified team has the expertise and experience to handle even the most complicated cases, and we have ready access to other specialists if issues arise.

To schedule an appointment, please call (631) 444-4121 (Surgical Care Center).

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